Objective To analyze the 2023-2024 sentinel hospital surveillance results for multiple respiratory pathogens in Tianshui city, Gansu province, and to understand the pathogen spectrum and epidemiological characteristics of acute respiratory infections.

Methods Specimens were collected from 1704 patients with acute respiratory infections who sought care at sentinel hospitals in Tianshui city in 2023− 2024. A multiplex fluorescence quantitative PCR assay was used to detect 21 common respiratory pathogens. Excel 16.61 and SPSS 25.0 were used to statistically analyze pathogen detection results across different sexes, seasons, age groups, and among inpatient and outpatient cases.

Results Among the 1704 patients, the overall pathogen positivity rate was 58.04%. The highest positivity rate occurred in winter (67.23%), indicating the peak season for infections. Adolescents aged 6–17 years exhibited the highest incidence of respiratory pathogen infections. Haemophilus influenzae had the highest positivity rate at 24.82% (423/1704). A total of 409 patients showed mixed infections with two or more pathogens. Significant differences were observed in the detection rates of Klebsiella pneumoniae (χ²=4.686, P=0.030) and parainfluenza virus (χ²=4.030, P=0.045) between males and females. Bacterial positivity (50.76%) exceeded viral positivity (35.45%). The positivity rate was higher among outpatients (67.49%) than inpatients (32.51%), whereas mixed-infection positivity was higher among inpatients than outpatients. Certain pathogens also showed statistically significant differences in positivity rates between inpatient and outpatient cases (all P<0.05).

Conclusion Detection rates of different pathogens varied significantly by age and season, with alternating prevalence patterns and a high proportion of mixed infections.Surveillance and control of acute respiratory pathogens should be strengthened.